Unexplained Rapid Heartbeat? Could indicate Tachyarrhythmia

In a normal person the heart rate changes in response to physical activity, stress and sleep etc. However, there are certain conditions where the heart beat can become abnormally fast due to disease processes. This is called Tachyarrhythmia. This can cause symptoms such as palpitations, dizziness and fainting.

What Is Tachycardia?

Tachycardia is a condition where the heart beats faster than normal, usually over 100 beats per minute. The pattern on ECG can be normal or abnormal

What Are The Different Types Of Tachycardia?

Broadly there are three different types :

• Sinus Tachycardia: Occurs when the sinus node, which controls the heart’s natural rhythm, signals the heart to beat faster. It is usually a normal response to physical exertion, fever, dehydration, or anxiety. However, if it happens frequently without an obvious cause, further evaluation may be needed.
• Supraventricular Tachycardia (SVT): A broad term for fast heart rhythms that begin in the upper chambers of the heart. Episodes may come on suddenly and last for minutes or hours before stopping abruptly. SVT can cause palpitations, dizziness, and chest discomfort. It is often not life-threatening but requires treatment if episodes are recurrent.
• Ventricular Tachycardia: Originates in the lower chambers (ventricles) and can be more serious. A rapid ventricular rhythm may prevent the heart from pumping enough blood to the body, leading to dizziness, fainting, or even life-threatening complications. This type often occurs in people with underlying heart disease or previous heart attacks.

Temporary Or Lifestyle-Related Causes

These factors can cause a temporary increase in heart rate, which usually resolves once the trigger is removed:

• Physical activity: Exercise naturally raises the heart rate, but a healthy heart returns to its normal rhythm after rest.
• Stress and anxiety: Emotional distress causes the body to release stress hormones, which can trigger a faster heartbeat. Prolonged stress may contribute to chronic tachycardia.
• Fever and infections: A high temperature increases metabolism, making the heart work harder to circulate blood and regulate body heat.
• Caffeine, alcohol, and nicotine: These stimulants affect the nervous system and can lead to a faster heart rate, especially when consumed in large amounts.
• Dehydration: When the body loses too much fluid, blood volume decreases, making the heart pump faster to maintain circulation.
• Medications and drug use: Certain decongestants, asthma inhalers, diet pills, and recreational drugs can overstimulate the heart, leading to tachycardia.

Sinus Tachycardia

Underlying health issues can cause persistent tachycardia, requiring medical evaluation and treatment:

• Heart disease: Conditions like coronary artery disease, heart failure, or valve disorders can interfere with the heart’s electrical system, leading to abnormal rhythms.
• High blood pressure (hypertension): Increased pressure forces the heart to work harder, which may lead to an elevated heart rate over time.
• Anaemia: A low red blood cell count reduces oxygen supply to the body, causing the heart to beat faster to compensate.
• Thyroid disorders: An overactive thyroid (hyperthyroidism) produces excess hormones that stimulate the heart, leading to an increased heart rate.
• Electrolyte imbalances: Potassium, sodium, calcium, and magnesium play a key role in heart function. Imbalances can disrupt electrical signals, causing tachycardia.
• Lung conditions: Chronic obstructive pulmonary disease (COPD), pneumonia, or blood clots in the lungs can strain the heart, forcing it to beat faster.
• Postural orthostatic tachycardia syndrome (POTS): A condition where the heart rate rises abnormally when standing up, often due to nervous system dysfunction.

What Are The Symptoms Of Abnormal Tachyarrhythmias?

Tachyarrhythmias can cause a range of symptoms, varying from mild to severe depending on the underlying cause of heart rate. Some individuals may experience no symptoms at all, while others may feel significant discomfort. Common symptoms include: 

• Palpitations: An abnormal sensation of the heart pounding or racing in the chest.
• Dizziness or lightheadedness: A feeling of unsteadiness, sometimes leading to fainting or near-fainting.
• Shortness of breath: Difficulty breathing, even during rest or minimal physical activity.
• Chest discomfort or pain: A tight, heavy, or painful feeling in the chest, often accompanied by pressure.
• Fatigue: Feeling unusually tired or weak, even without physical exertion.
• Fainting (syncope): A temporary loss of consciousness due to inadequate blood flow to the brain, often linked to severe cases of tachycardia.
• Confusion or difficulty concentrating: Insufficient blood flow to the brain may affect mental clarity, leading to confusion or difficulty focusing.

If these symptoms occur frequently or are severe, it is important to seek medical advice to determine the cause and assess the need for treatment.

How Is Tachyarrhythmia Diagnosed?

Diagnosing tachycardia involves understanding the patient’s symptoms, lifestyle, and conducting various tests to pinpoint the exact type and cause of the condition. The diagnostic process typically follows these steps:

Medical History and Physical Examination

• The doctor will start by asking detailed questions about the patient's symptoms, such as when they occur, how often, and their severity. Any family history of heart disease or arrhythmias will also be noted.
• A physical examination may be performed to check for signs of heart disease, lung issues, or other conditions that could be contributing to the rapid heartbeat.

Electrocardiogram (ECG)

• A 12-lead ECG is the primary tool for diagnosing tachycardia. It records the heart's electrical activity through electrodes placed on the skin, helping the doctor identify abnormal rhythms. An ECG can determine the heart rate and show if the rhythm is regular or irregular, indicating the presence of tachycardia.

Holter Monitor

• A Holter monitor is a small, portable device worn for 24-48 hours that records continuous heart activity. It’s useful for capturing episodes of tachycardia that may not occur during an ECG recording. The patient records symptoms during the monitoring period, helping the doctor correlate the heart's rhythm with any discomfort or events.

Echocardiogram

• An echocardiogram uses sound waves to create an image of the heart. This test helps doctors assess the heart’s structure and function, detecting issues such as enlarged chambers, damaged valves, or poor blood flow, which could contribute to tachycardia.
• It also helps to evaluate the heart's pumping efficiency, which can be affected if tachycardia is long standing.

Blood Tests

• Blood tests are essential in identifying underlying conditions like anaemia, thyroid dysfunction, or electrolyte imbalances, all of which can trigger tachycardia.
• Common tests include measuring levels of potassium, magnesium, calcium, thyroid hormones, and red blood cell count.

Electrophysiological Study (EPS)

• An electrophysiological study (EPS) is used for more complex cases of tachycardia. It involves inserting thin catheters into the heart via blood vessels to map the electrical activity and identify abnormal pathways that might be causing the arrhythmia.
• This test is often done when other methods haven’t provided a clear diagnosis or when treatment options like ablation are being considered.

By combining the results from these tests, doctors can diagnose the specific type of tachycardia, determine the underlying cause, and plan the most appropriate treatment or management strategy.

What Are The Treatment Options For Tachyarrhythmias?

Treatment for tachyarrhythmia depends on its type, severity, and underlying cause. The main goal is to slow down the heart rate, restore normal rhythm, and address any contributing factors or health conditions. Common treatment options include:

Lifestyle Changes and Home Remedies

• Avoiding triggers: Reducing or eliminating substances like caffeine, alcohol, nicotine, or recreational drugs that can cause or worsen tachycardia.
• Managing stress: Practising relaxation techniques such as deep breathing, meditation, or yoga to lower stress levels and reduce episodes of rapid heart rate.
• Staying hydrated: Ensuring proper fluid intake, as dehydration can contribute to tachyarrhythmia.

Medications

Several medications may be used to treat tachyarrhythmia, depending on the cause and type of arrhythmia:

• Beta-blockers: These medications slow the heart rate by blocking the effects of adrenaline, helping the heart beat more slowly and steadily.
• Calcium channel blockers: These reduce the heart’s electrical activity and can help manage certain types of tachycardia by slowing the heart rate.
• Antiarrhythmic drugs: These medications work to regulate the heart’s rhythm and prevent abnormal heartbeats.
• Blood thinners (anticoagulants): In some cases, these may be prescribed if tachycardia increases the risk of blood clots or stroke, especially in patients with atrial fibrillation.

Cardioversion

• Electrical cardioversion: This procedure involves delivering a controlled electric shock to the heart to reset its rhythm. It is typically used in cases of atrial fibrillation, atrial flutter, ventricular tachycardia or other types of arrhythmias that don’t respond to medication.
• Pharmacological cardioversion: Certain medications may be used to convert the heart back to a normal rhythm, particularly for atrial fibrillation or atrial flutter.

Catheter Ablation

This procedure is used for certain types of tachycardia, such as supraventricular tachyarrhythmia or ventricular tachyarrhythmia. It involves threading a catheter through blood vessels to the heart to interrupt the abnormal electrical pathways causing the rapid heartbeat. Ablation is often used when medications or other treatments are not effective or tachyarrhythmias are recurrent.

Pacemaker or Implantable Cardioverter-Defibrillator (ICD)

• Pacemaker: A small device implanted under the skin near the chest to regulate the heart's rhythm. It sends electrical signals to the heart when it detects abnormal rhythms or slow heart rates.
• ICD: An implantable device that monitors the heart and delivers shocks if a dangerous arrhythmia, such as ventricular tachyarrhythmia, is detected. It is often used in high-risk patients to prevent sudden cardiac arrest.

Surgery

• In rare cases, surgery may be needed to treat tachyarrhythmia if the heart's structure is significantly affected. Surgical options may include procedures to correct heart valve problems or repair damaged tissue.

Consult Today

If you're experiencing symptoms of tachyarrhythmia or have concerns about your heart health, getting the right support is crucial. At Max Hospital, our team is ready to assist with diagnosis, treatment, and management to help manage the condition. Don’t wait for your symptoms to become more serious—reach out to us today to schedule a consultation and take the first step toward a healthier heart.